Colorado § 10-16-209 - Application for policy.

§ 10-16-209. Application for policy.

(1) The insured shall not be bound by any statement made in an application for a policy unless a copy of such application is attached to or endorsed on the policy when issued as a part thereof. If any such policy delivered or issued for delivery to any person in this state is reinstated or renewed, and the insured or the beneficiary or assignee of such policy makes written request to the insurer for a copy of the application, if any, for such reinstatement or renewal, the insurer, within fifteen days after the receipt of such request at its home office or any branch office of the insurer, shall deliver or mail to the person making such request a copy of such application. If such copy is not so delivered or mailed, the insurer shall be precluded from introducing such application as evidence in any action or proceeding based upon or involving such policy or its reinstatement or renewal.

(2) No alteration of any written application for any such policy shall be made by any person other than the applicant without the applicant's written consent; except that insertions may be made by the insurer, for administrative purposes only, in such manner as to indicate clearly that such insertions are not to be ascribed to the applicant.

(3) The falsity of any statement in the application for any policy covered by part 1 of this article or this part 2 may not bar the right to recovery thereunder unless such false statement materially affected either the acceptance of the risk or the hazard assumed by the insurer.

Source: L. 92: Entire article R&RE, p. 1670, § 1, effective July 1.

Editor's note: This section is similar to former § 10-8-111 as it existed prior to 1992.

ANNOTATION

Annotator's note. Since § 10-16-209 is similar § 10-8-111 as it existed prior to the 1992 repeal of part 1 of article 8 of this title, a relevant case construing that provision has been included in the annotations to this section.

The effect of this section is: (1) To bar the insurer from defending against liability to the insured under a policy, on the basis of statements in an application not attached to the policy; and (2) even when the application is attached, to bar the insurer from denying recovery unless the false statement involved materially affected the acceptance of the risk or hazard assumed by the insurer. Fallis v. Zurich Ins. Co., 28 Colo. App. 235, 472 P.2d 174 (1970).

The provisions of this section and § 10-8-116 do not require attachment of a copy of the individual member's application for coverage under group health insurance policy to that policy, or to the certificate of coverage issued thereunder, and the trial court's conclusion to this effect is not in error. Fallis v. Zurich Ins. Co., 28 Colo. App. 235, 472 P.2d 174 (1970).

A group member, as a member of the farm bureau, is not the applicant for a "policy", but only the applicant for a certificate of coverage under the policy. Colorado farm bureau is the applicant for the group "policy". Further, no "policy" is ever issued to the group member, to which his application must have necessarily been attached; but only a certificate of coverage. Fallis v. Zurich Ins. Co., 28 Colo. App. 235, 472 P.2d 174 (1970).

If representations made in answer to specific questions material to the risk are untrue, the policy will thereby be rendered void, and it is immaterial whether such answers be considered warranties or representations, or whether they were made with the intention to deceive the insurer or without such intention. Fallis v. Zurich Ins. Co., 28 Colo. App. 235, 472 P.2d 174 (1970).

Finder of fact may determine falsity a materiality of answers. The trial judge, as finder of fact, could conclude: (1) That the answer given by a group member regarding his wife's prior medical history, although true to the extent given, was nevertheless false, by omission of mention of several previous, similar illnesses of which the group member was completely aware; and (2) that it therefore constituted a material, fraudulent misrepresentation. Fallis v. Zurich Ins. Co., 28 Colo. App. 235, 472 P.2d 174 (1970).